Exercise intervention for the Prevention, Management and Rehabilitation from Metabolic Syndrome

About this Research Topic

Background

Metabolic syndrome (MetS) is characterized by central obesity, dyslipidemia, hypertension, and hyperglycemia (1). Prevalence of MetS is as high as 80% among sedentary adults with obesity (2), resulting in increased risk for cardiovascular disease, and premature death (3). MetS treatment generally requires polypharmacy, but even after using several medicines, individual risk factors are not always well controlled (4-5). Low levels of cardiorespiratory fitness (CRF) and strength have been identified as an independent and strong predictor of mortality compared to classical risk factors (6). Both aerobic fitness level and skeletal muscle mass are low in individuals with MetS (7-8), and it is possible that their low aerobic capacity and muscular power underlie the metabolic and cardiovascular abnormalities that compose their syndrome. On the other hand, exercise training is widely recommended to improve CRF and strength in healthy individuals and MetS patients because it improves some of the MetS components (9-10).

Metabolic syndrome (MetS) is a disorder of a multisystemic nature that affects approximately one third of the adult population worldwide. Due to the progressive aging of the population and the fact that obesity is becoming more prevalent, some researchers tend to think that MetS will be the most common medical problem of the 21st century.

People with MetS are often sedentary and overweight, so an effective management strategy for MetS would be a multifactorial lifestyle change. Among the possible modifications in lifestyle, the efficacy of caloric restriction and the practice of continued physical exercise has been demonstrated, both as primary and preventive treatment. The current guidelines are based on the available evidence on the impact of lifestyle modification on the individual risk factors that constitute MetS. For example, weight loss has a positive impact on all MetS risk factors, while physical exercise improves energy balance, reduces insulin resistance and blood pressure, and increases maximal aerobic capacity, which in turn reduces the risk of cardiovascular disease and mortality. Therefore, in this research topic, we propose to continue gathering evidence on the impact of exercise on MetS management.

Prevention is essential so that the metabolic syndrome (MetS) does not trigger diabetes and coronary artery disease.
Scientific studies have shown that programs of more than 8 weeks of exercise-training result in alleviation of the factors that compose the MetS (i.e., diabetes, hypertension, obesity, and dyslipidemia). In this research topic, we propose to study in an integrative way how different physical exercise programs can improve the health of patients with MetS. In this topic we welcome studies on the impact of different interventions on MetS ,with a special interest in new research on the effect of different types of exercise (i.e., volume, periodization, etc), interactions between exercise and drugs (i,e., analysis of cost-effectiveness, evolution in the use of medications [ATC/DDD index], etc), different methodologies on weight loss (i, e intermittent fasting, caloric restriction, lifestyle modification, etc).

1. Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of obesity. Circulation. 2009;120(16):1640–5.
2. Kolovou GD, Anagnostopoulou KK, Salpea KD, Mikhailidis DP. The prevalence of metabolic syndrome in various populations. Am J Med Sci. 2007;333(6):362–71.
3. Gami AS,Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: A systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49(4):403–14.
4. Lillich FF, Imig JD, Proschak E. Multi-Target Approaches in Metabolic Syndrome. Frontiers in pharmacology 2021;11:554961-554961.
5. Morales-Palomo F, Moreno-Cabañas A, Ramirez-Jimenez M, Alvarez-Jimenez L, Valenzuela PL, Lucia A, et al. Exercise Reduces Medication for Metabolic Syndrome Management: A 5-Year Follow-up Study. Med Sci Sports Exerc 2021;53(7):1319-1325.
6. Blair SN, Kampert JB, Kohl HW3rd, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276(3):205–10.

Keywords: Metabolic syndrome, Exercise, Diabetes, Dyslipidemia, Hypertension, Medication use

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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